Meeting requirements for survivorship visits: Interventions for patient identification.

Abstract

59 Background: A major challenge in providing quality survivorship care to cancer patients is efficiently and effectively identifying and scheduling patients who need a Survivorship Visit (SV). While the Commission on Cancer (CoC) Standard 3.3 defines which patients require a Survivorship Care Plan (SCP), staff need to operationalize the definition and search the clinic’s patient records on a regular basis to accurately identify eligible patients. This is a challenge for a busy cancer center. Methods: In July 2017 the Judy DiMarzo Cancer Survivorship Program instituted a full time Data Analyst (DA) to assist in identifying survivors using the OncoLog Cancer Registry and the Electronic Medical Record (EMR). Previously the identification process was limited to the EMR, and the Survivorship Program Nurse Coordinator (NC) was a combined role overseeing metrics, identifying patients and assisting with SVs. Currently the DA has piloted a method extracting data monthly from OncoLog and the EMR to assess eligibility of Standard 3.3. The data is compiled and sent to the NC who assists the cancer-specific service lines responsible for the patients identified to ensure SVs occur in a timely manner. Results: Our pilot intervention resulted in a 283% increase in SVs per month, from an average of 30 SVs to 115 SVs per month. The overall achievement for the CoC SV delivery requirement increased from 16% prior to the intervention to 33% in just 3 months. GI increased from 5% to 20%. Lung increased from 16% to 39%. The average SV was 3 months after the end of treatment. Approximately 60 hours was dedicated to establishing this method and 35 hours per month in the eligibility, identification process. Conclusions: By adding a DA role, extracting data from Oncolog and the EMR, as well as increasing accountability at the service line level to improve identification and scheduling of eligible patients, the delivery of SCPs to eligible patients substantially increased. Nevertheless this process is time consuming and will likely not be sufficient to ensure that all eligible survivors receive appropriate care. Consequently, additional, systematic improvements in this process should be explored such as EMR methodologies to automate patient identification.